hello there.
hello.
are you all right?
yes thank you.
okay so you booked in because you have an eye problem haven't you? that's right I woke
up this morning and my right eye was a bit sore and when I went to the bathroom I noticed
it was red so I thought there might be something major with this I'll get it checked out.
okay so that's only the right eye?
yeah.
okay.
the left eyes fine.
all right any loss of vision in each eye?
no. have you tried comparing just by?
yeah.
definitely.
I went like that and like that and the vision seems the same.
right right anything like this ever happened before or not?
no.
any discharge?
no.
no. okay you say it's more sore than painful?
yeah it's not really it's not unbearable.
no. but I can feel that eye.
okay what pain score out of ten would you give it?
three possibly.
about a three?
yeah.
all right how's your health at the moment?
it's fine.
right how's your blood pressure?
as far as I know my blood pressure is great.
right diabetes?
I've got that.
okay is it under control?
it's under control.
what about cholesterol?
my cholesterol was okay my last check.
right.
right okay that's fine um we'll get some tests done try and get to the bottom of things.
okay
okay if you hold that for me about 40 cm just going to cover the left.
what's the smallest row that you can read?
six six.
have a go.
OXV.
what is the vision like through the left?
just the same OXV.
okay any difference in clarity between the two?
if anything I'd say it's slightly clearer in the right eye.
so the one that's red?
yeah.
okay
have you experienced any increase in floaters in your vision at all?
no no.
any flashing lights since?
no.
right any halos around lights?
no. okay so there's just that soreness?
yeah.
no discharge nothing else?
okay just a near Vision check here
smallest you can read there.
OKV
do you want me to read the same again?
yeah.
it's OKV.
okay is it still clearer through the right?
no for the reading it's about the same in both. is it?
okay thank you all right
all right
okay I'll just turn the lights off
okay just focusing on the distance target for me please
pupils are working fine to the light
Just take your glasses off for me now
okay looking straight ahead there's a light coming from the side
checking the anterior angle there
keep looking straight ahead please I think the pupils are looking
equal in size
there's no anisocoria
looking straight ahead expecting a smaller size now
four mil in the left in the right sorry
and four in the left so pupils and no problems
not noticed any double vision since the redness?
no. excellent
I think it's going to be a good idea to check your eye pressures.
that's a fancy looking gadget
okay so essentially a little sterile probe flicks the eye.
right does it hurt?
no you might just be aware of it touching your eye but it doesn't hurt. for this test
no
anaesthetic drops are required right so your job is to look straight ahead, both eyes open
and breathe normally
it's going to rest against the forehead
okay it's 21.
let's use a fresh probe for the other eye.
right okay.
just in case it's an infection we don't want to cross contaminate
okay looking straight ahead again
20.
they're very similar
okay just looking up for me.
I'm going to have a gross look
okay looking to the right hand side
to the left, a bit higher, lets have a little look
on the temporal side you have the most redness at the moment looking down for me
it's more on this side isn't it, on the temporal side? that's where I noticed it.
yeah about 1.5 rest of the eyes, rest of the zones and in the left eye is about 0.5 on
this grading scale.
right
yeah okay I've got some more equipment to take a better look there with some more magnification
but what I want to do is I want to pop some yellow dye in the eye first before doing anything
else
this checks for any damage
particularly focusing on the cornea
okay now this doesn't sting
it doesn't blur the vision either, in fact it's completely painless
just need to
wet the tip
going to do both eyes as well so just looking up for me
okay just take a few blinks now
and we also have a corneal grading scale there
which I can refer to
okay going to use some bright blue light now
looking off into the distance to start with
the Burton lamp, just look through the window if it blocks your view
and then looking up to the ceiling.
okay just remember to Blink to reduce tear breakup time look left
look to the right
now look down
straight ahead again
there's no corneal staining there
straight again
blink
looking up
looking right
left
down.
Just lift the lid again
excellent so no corneal staining in either eye, that's a good sign.
the tear break up time is a little bit low so that means, after a blink within a few
seconds the tears are evaporating.
have you ever been diagnosed with dry eyes?
nope
I do know I suffer from it occasionally.
what kind of symptoms do you get?
it's in the morning more than anything my tears tend to run down my cheeks.
do they?
it doesn't happen every day but sometimes.
do you get any grittiness?
a little bit, it's more like the salt in the eye.
do you want to use any ocular lubricants?
I just blink a few times, dab it with a bit of tissue and it's fine.
okay keep looking straight ahead again as promised I want to have a look with the white
light again just to further assess the redness.
looking left for me it's on the temporal side
now to the right and down
and up
temporal sided redness about 0.15
right again
and left
and down
and up
no signs of blepharitis either
I'm also not seeing any uh inflammation of the lids.
all right.
okay I haven't seen any discharge, which is good, there's no damage to the window part
of your eye, there's now fat growths on the eye either, which we call pinguecula, in some
cases they can become a bit inflamed if you get a fat growth.
right.
but there's no signs of any of that either
just to be safe I need to look inside the eyes.
I'm going to get a bit closer, all right just to rule every possibility out, or rule out
anything Sinister at least.
chin up a little bit, looking straight ahead
okay so the optic nerve is pink and it's defined
No sectoral hyperaemia, fairly deep cup, estimate point six five
look down just going to raise the lid
no look to the left
and right
and up
straight ahead
looking into the light this time
clear macular too
look straight ahead
good I can't see any retinal pathology
why are you using a green light at this stage when it's been a white light all the other
times?
it just asked me to better visualise the blood vessels.
right.
they show up as black rather than standard pinky red colour
okay straight ahead let's check the left
just looking at cranial nerve number two to start with
particular landmark
it's defined, good colour
no obvious swelling or hyperaemia
just looking into the light okay
looking to your right hand side
and left
and down
and up again
just finally up and left
straight ahead again
excellent let's just get the lights.
good I think we've ruled out anything sinister.
oh good.
so there's nothing, there's no closure of the angle of the eye, the pressures are good,
the pupils are working normally, the optic nerve looks fine.
in terms of the front, where it's occurred, the redness, is no signs of any infection.
what I'm thinking is just on that one side you might have a little bit of something called
episcleritis.
what's that when its at home?
it's just where the vessels of the the episclera just become a little bit inflamed.
right.
sometimes there's no apparent cause.
do you have any inflammatory conditions at all? have arthritis, no IBS or anything like
that?
no.
right I'm going to see you again in a couple of days by which time it should have subsided
and I don't think any treatment is necessary at this point.
right.
so just put up with the mild soreness for today, it might be that it's better tonight
or tomorrow.
okay.
all right if I'm going to book you in for two days, but if anything flares up, so if
it gets worse or you develop any new symptoms, you need to come back in again.
okay.
all right okay.
yeah.
so you should be fine or I'm at least going to recommend ocular lubricants.
okay.
I think in cases like this it might just make the eye feel a little bit more comfortable
and especially with some dry eyes.
any specific ones?
well you can try these.
right.
it's a couple of samples left this is the xailin fresh.
okay.
it's preservative free and it contains carmellose 0.5 percent, so they're completely safe to
use.
aim to use this in the right eye three or four times a day, a couple of times in the
left and just see what it does for you.
okay.
all right especially with the grittiness.
all right.
so you could use it before bed.
and then when I get up in the morning.
one in each eye and then a fresh one in the morning.
all right.
so you remember to use a fresh one each time.
okay.
all right so they're single use just bin them when you're finished.
right.
okay I think that's it see you in a couple of days.
excellent thank you very much